Lucy's numbers going down...what to do?

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123joan

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+11 207
+12 176

Her appetite hasn't been voracious, as it was before the puking episode four days ago, which I attributed to switching FF flavors.
I just fed her, and plan to give her half a dose of insulin in 30 minutes.
Is that a good idea? I hope I get advice soon, I'm waffling between doing that and skipping the dose entirely.
 
Next time, wait 30 minutes without feeding, and shoot if you see a number that isn't falling....
But for tonite, assume you'll see a higher number from the food in 30 minutes. A reduced dose should be okay, but if you shoot, get another test by +3 or +4 to see what she looks like once the insulin starts to onset?
If you see a lower number in 30 minutes, then I'd say "skip" tonite.
Carl
 
You mean that I should test again in 30 minutes even though she ate? This is so hard. My decision making skills are coming to a standstill.
 
Yes, test again before shooting. If it is still dropping after food, you would not want to give insulin. Her pancreas would be helping on its own.
Carl
 
Joan,
Your decision making skills are not leaving you. You just need a self-confidence booster. :smile:
As confusing and frustrating as this diabetes thing is, it isn't rocket science. It's just a big huge stressful pain in the backside. Lucy's numbers since you upped to 1.2 are good numbers. You've just been faced with a couple of confusing PS numbers that have been lower than you expected to see, right? The reduced dose the other night worked fine. So will tonight's .4u.

What I was trying to communicate (on my tablet which takes too long to type on) earlier was this -

When you see a number at shot time that is lower than any other number you've seen since the last shot, one thing you want to know before shooting is whether the number is rising, or whether it's been dropping all day long. The only way to know that is to stall the shot, but don't add food into the equation. Food is supposed to cause an increase in BG. So if you feed, it should go up. But you still don't know if it was coming up or not before that food. So it just confuses the issue.

OK, for this cycle - you would expect the number to go up from the food. And you would expect it to go down some due to the shot. So what you do is check 3 or 4 hours after the shot, to see if (and how much) it drops. If you see a significant drop by that time, then you can expect it to keep coming down until nadir time. There are two courses of action at that point.
1 - you just leave things alone, and keep testing every hour or so, to look for a low number. If it gets lower than you feel comfortable with, you feed her some higher carb canned food, just a spoonful or two, and that should "buffer" the drop and get her past her nadir without going too low.
Or
2 - you just feed her a snack of her normal food at +3 or +4, and that should slow the drop or stop it.

Those options are both okay, and which one you choose depends on how comfortable you are with "low" numbers. It also depends on what your schedule looks like for the rest of the cycle. If you need to go to sleep because you're a normal mortal human like the rest of us :lol: , then you can "abort" the cycle by feeding to keep the numbers from going low and keeping you up all night. If it's the middle of the day, and you're going to be around to test and keep an eye on her, then you can be less conservative and test and let the cycle go where it's going. Only intervene if you feel you need to. The important thing is to gather data if that is practical, so that in the future, you have a better idea of what a dose, or food, will do over a 12 hour cycle. It only gets "scary" when you see a 40 or 50 on the meter that makes your eyes bug out and your heart beat a little faster. It also depends on when that low number happens in a cycle. If it happens at +4, then it's a bit more of a concern than if it happens at +6 or +7 when it should be at or past nadir time.

The important thing to remember is that food can be your biggest ally when you see an uncomfortably low number. As long as you have the supplies you need, and you're watching, Lucy is going to be fine.

Chin up!
Carl
 
Joan,
What I just posted was based on your spreadsheet saying ".4" on tonight's dose amount, but it looks like it says "skipped" now. Either way is fine. I think the .4u would be okay, but so is a skip.
Don't let this kick your butt, lady. ;-)
Carl
 
I input the .4 on the spreadsheet then chickened out, I did skip.
I DO NOT want my butt kicked by this.
Lucy Lucy Lucy.
Will have to reevaluate once again tomorrow morning, and try to learn more.
Thank you for chin up advice, came at a good time.
 
How to note this? Morning shoot was 16.5 hours ago, I skipped pm dose.
So is this +16.5?
I should have given her a half dose tonight. I spend too much time second guessing: this diabetes challenge is tough. We didn't want it! :evil:
But it's getting better. Tonight is challenging, I spend so much time trying to decide what to DO, dinner gets behind, work gets behind, clock keeps ticking. It's not easy, that's for sure.
 
Hi Joan,

I don't get here much these days but I used to be a regular. Interesting ss, I'll take a longer look at it later tonight.

Boy do I remember my early days here and overwhelmed is putting it mildly. Trust me, no one on this site is going to let this kick your butt, everyone is here to support one another, we cheer for others successes and grieve for others losses. We are all in this boat together, or were at one time. Learning the steps of this sugar dance we do with our kitties gets easier and easier as time go on. Hang in there.

I just wanted to point out that you shot the same dose on a similar PS today as you did yesterday so you might end up with a similar pattern today, which is good because now you can be ready for it.

Follow what Carl said.

If you can test 1 hour before PMPS you will be able to know if Ms. Lucy is rising or still dropping and that will take the pressure off at shot time. If she is rising but still has a lowish bg you can either wait until you get a bg that you are comfortable shooting or shoot a reduced dose.

If you do have a similar pattern as yesterday you might want to shave a bit off the dose and try a fat 1 unit.

I'll check back later.

Robin
 
So is this +16.5?
Joan,
Yes, that's right. When you skip a shot, your next test is just how ever many hours it's been since the last shot, all the way to +24 if you wait till the next "normal" shot time
Another note about skipping a shot. If you do that, it gives you a great opportunity to adjust your normal shot time if you want to do that. Let's say you regularly shoot at 8am, but you'd prefer shooting at 6am and 6pm (like if your schedule gets changed at work or whatever). Once you've skipped a shot, you can shoot at any time you want after that, and that becomes your new "normal" shot schedule, like 6am and 6pm, or 7 am/pm, or whenever. Just something to keep in mind if life makes a time change necessary...

Carl
 
I've been able to test a couple of times today.
AMPS 182
waited half hour
218
1 unit ProZinc
+5 345
+ 7.5 331

I'll test her again in two more hours, then better stock up on supplies.
I probably would have been ok shooting at 182, but I hadn't had coffee yet and chickened out once more.
 
Hi Joan, great that you got some mid cycle numbers.

If Lucy's PMPS drops back down, that will complete an inverse cycle. Which usually means too much insulin. She had a similar curve a few days ago.

Looking back through your ss it looks like you were getting some nice cycles on .6 unit into a mid 300 bg.

If today does end up as an inverse curve it might be worth looking at lowering the dose or going to a sliding scale.
 
+11 = 280
Still going down.
I can test in 45 more minutes, then I have to feed them and get on with other things. If it's still going down I will shoot .6 unless someone tells me to skip.

Inverse cycle: I don't know how I can wrap my head around that.

I remember reading about the inverse cycle a month or so ago, will have to dig through posts and see if I can find that theory. I barely understand the regular cycle!
 
+12 = 288
Obsessing!
Will give her lower dose.
We were using sliding scale for weeks, new plan was stick to a dose, now back to sliding scale?
I am going to give her a half dose tonight, .6
AMPS 182
waited half hour
218
1 unit ProZinc
+5 345
+7.5 331
+11 280
+12 288
Half dose tonight .6
How much testing is too much testing? I want to be proactive but not CRAZY
 
In the beginning it's mostly trial and error looking for what works for Lucy. A sliding scale worked for me but not for others.

What scale were you using, I don't remember seeing one on your ss. I take it that it wasn't working well.

Testing, the more tests you get in the more data there is to analyze, especially in the beginning so test away. A +4 will tell you where the cycle is headed and if she's dropping too fast you can slow the drop with food. A +6 to +8 looking for nadir. But since we have lives beyond our extra sweet kitties any test will be helpful. A test before bed or in or out the door, if she is acting funny or off. With Harley he would come and get in his testing spot if he was going low so if he asked for a test I tested.

A few of us here were told by our loving friends and family that the CRAZY ship had already sailed when we started treating our diabetic cats :lol: so you're in good company here.
 
Well, your crazy ship remark made my day. THANK YOU. I'll paste my previous sliding scales tomorrow on a brand new thread.
 
Yup we sailed away on the CRAZY ship treating our diabetic cats to the land of "CRAZY internet cat people". :lol:

I have to work tomorrow and every week day so I'll post the scale I came up with now. We'll see how close I come to your scale.

Lucy's Sliding Scale

Over 400 - 1 unit
375 to 399 - .8
300 to 374 - .6
250 to 299 - .4
200 to 240 - .2

The scales need to be watched and tweeked as you go along, if one level of the scale isn't working you change that level.

If she is in a bounce you don't shoot by the scale or you could get into trouble. Instead shoot the last dose again and evaluate why she bounced and if that dose needs to be lowered. Etc.
 
I find Lucy fascinating (I am sure you would say frustrating, Joan) she reacts to such a tiny change in insulin. Going from one unit to 1.2 really made a difference. I don't know if that speaks well to trying the sliding scale again or .8 would be worth a try.

As Robin says, the more data the better, particularly with Lucy where things seem to change so often. I think any variation is worth a try, with monitoring so we can try to figure her out - again.
 
Well, I'm am happy that you find her fascinating! You are right, it is not fascinating to me, it is frustrating. I'm spending so much time trying to decide what to do it's pathetic. No boredom over here at our house. It's hard to believe that such tiny tiny dose changes makes such a difference, but evidently it does.
Today
AMPS = 411
1 unit
+6.5 = 314
I get flustered at shot dose decision time, the two cats hovering and picking on each other for their dinner, I'm usually behind with getting the Human's meals together. Chaos and cat food. I understand this isn't a piece of cake. Plus yesterday I found a FLEA! HORRORS! on her ear while doing a BG test. Indoor cats, must be my fault, I must have tracked the horrid pests in from the yard. I picked up a new flea treatment (Vectra) from our vet this morning. Hopefully it will work like a charm. Petey (other cat) abhors flea treatments, and begins salivating and freaking out the minute I touch it to his shoulder blades. He has fully recovered from this morning's event.

Still don't know what to do with Lucy tonight. .8 or one unit?
 
Hmmm. Well, the .6 didn't seem to do too much, but that could have been a bounce from a lower number overnight (not likely, IMHO) or it may do more if you stick with it awhile. (not sure about that either.) I have to admit I like .8 if the pmps is in the 250 - 300 range tonight. The one unit may have been too much, but not a whole lot too much and the .6 is almost half that. And we know she responds to tiny changes...... IF she is in the 200 range, .6 might be fine.

Could you get everyone a tiny low carb snack at shot time, to settle things down so you can test Lucy? It won't affect her numbers and it might destress (is that a word?) the situation a little?
 
Sorry I missed the part where you already tried the sliding scale.

I like Sue's suggestion on the .8 unit. If you look back at the begining of your ss she was doing pretty well on .6 & .8 unit doses with more blues than she's getting now.

Yikes fleas, nasty little things.
 
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